Melanoma (cont.)

Alan Rockoff, MD

Dr. Rockoff received his undergraduate degree from Yeshiva College with the distinction of Summa Cum Laude. He received his medical degree from the Albert Einstein College of Medicine. His internship and two years of Pediatric residency were at the Bronx Municipal Hospital Center, followed by training in Dermatology at the combined residency program at Tufts and Boston Universities. Dr. Rockoff is certified by both the American Board of Dermatology and the American Board of Pediatrics.

Frederick Hecht, MD, FAAP, FACMG

Frederick Hecht, MD, lives in Scottsdale, Arizona. Dr. Hecht is a Pediatrician and Medical Geneticist and is certified by both the American Boards of Pediatrics and Medical Genetics. Dr. Hecht was born and raised in Baltimore and attended Dartmouth College in Hanover, N.H. and the Sorbonne at the University of Paris receiving his BA degree cum laude with distinction from Dartmouth.

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

A history of intense, intermittent sun exposure, especially in childhood

Many (more than 100) moles

Large, irregular, or "funny looking" moles

Close blood relatives -- parents, siblings, and children -- with melanoma

The presence of close (first-degree) family with melanoma is a high risk factor, although looking at all of melanoma, only 10% of cases run in families.

How do I estimate my level of risk for melanoma?

The best way to know your risk level is to have a dermatologist perform a full body examination. That way you will find out whether the spots you have are moles and, if so, whether they are "funny looking" in the medical sense.

The medical term for such moles is "atypical." This is a somewhat confusing term, because among other things the criteria for defining it are not clear, and it's not certain that an atypical mole is necessarily precancerous. If you have such moles, your doctor may do a biopsy in order to counsel you about the need for surveillance or further testing.

Sometimes, you learn at a routine skin evaluation that you do not necessarily need annual routine checkups. In other situations, your doctor may recommend regular checks at six-month or yearly intervals.

What are the types of melanoma?

The main types of melanoma are:

Superficial spreading melanoma: This type accounts for about 70% of all cases of melanoma. The most common locations are the legs of women and the backs of men, and they occur most commonly between the ages of 30 and 50. (Note: Melanomas can occur in other locations and at other ages as well.) These melanomas are often barely raised and have a variety of colors. Such melanomas evolve over one to five years and can be readily caught at an early stage if they are detected and removed.

Nodular melanoma: About 20% of melanomas begin as deeper, blue-black to purplish lumps. They may evolve faster and may also be more likely to spread.

Lentigo maligna: Unlike other forms of melanoma, lentigo maligna tends to occur on places like the face, which are exposed to the sun constantly rather than intermittently. Lentigo maligna looks like a large, irregularly shaped or colored freckle and develops slowly. It may take many years to evolve into a more dangerous melanoma.

There are also other rarer forms of melanoma that may occur, for example, under the nails, on the palms and soles, in the eye, or sometimes even inside the body.